Knowledge, Hesitancy and Barriers to Uptake of Irreversible Contraceptives Among Women and Healthcare Providers: A Scoping Review

Irreversible contraceptives (female sterilization and vasectomy) are safe, cost effective, and highly effective methods of family planning, yet global uptake remains low (2 5% in many low and middle income countries) compared to 15 25% in high income settings. This scoping review maps existing evidence on knowledge, hesitancy, and barriers to uptake of irreversible contraceptives among women and healthcare providers. Following Arksey and O'Malley's framework, we searched PubMed, CINAHL, Scopus, and African Journals Online (2015 2025). Fifty three studies met inclusion criteria. Key findings: Knowledge gaps were pervasive—only 28 45% of women understood that irreversible methods do not cause cancer or weight gain, and 35 50% of providers could correctly counsel on vasectomy. Hesitancy dimensions included fear of regret (reported in 68% of studies), partner opposition (62%), religious/cultural prohibitions (54%), and concerns about surgical pain (48%). Barriers at health system level included lack of trained providers (72% of studies), absence of equipment/consumables (58%), and high out of pocket costs (44%). Only 19% of studies evaluated interventions to address barriers, and only 12% measured uptake as a primary outcome. Major gaps include underrepresentation of male partners (only 16% of studies included men), absence of validated hesitancy measurement tools, and lack of implementation research on provider focused interventions. This review highlights the need for multi level interventions addressing knowledge deficits, provider biases, and health system constraints.